Lower Pole Caliceal Stone Clearance After Extracorporeal Shock Wave Lithotripsy: The Effect of Infundibulopelvic Angle

Abstract

               Extracorporeal Shock Wave Lithotripsy (ESWL) represents the first choice therapy for renoureteral stone disease. Clinical controversy exists concerning the efficacy of ESWL for lower pole kidney stones. Nowadays, the factors that hindering the spontaneous passage of stone debris resulting from ESWL of lower caliceal stone are the gravity - dependent position of the lower pole calices and particular features of the inferior - pole collecting system anatomy.

                We studied the influence of the lower infundibulo-pelvic anatomy in the success of ESWL of lower caliceal stone size 10-20 millimeter in 50 patients with Storz Modulith SL -20 machine. At the mean follow-up of 6 months, 44 per cent of the Patients presenting an infundibulo-pelvic angle of lesser than 90˚ became stone free. On the other hand, 86% of the patients presenting an infundibuo-pelvic angle of greater than 90˚ became stone free. Our data suggested that acute infundibulo-pelvic angle of lower pole hindered the spontaneous passage of stone fragments after ESWL.